title: Prognostic significance of thrombocytosis, platelet parameters and aggregation rates in epithelial ovarian cancer.
abstract: OBJECTIVE
  The aim of this study is to investigate the impact of preoperative platelet counts, parameters and aggregation rates (maximal aggregation rate: MAR) on prognosis in patients with epithelial ovarian cancer (EOC).
  
  
  METHODS
  Preoperative platelet count, parameters and MAR in 182 EOC patients, 122 patients with benign ovarian tumor and 150 healthy women were retrospectively analyzed. The correlation between thrombocytosis, platelet parameters, MAR and clinicopathological factors were evaluated in EOC.
  
  
  RESULTS
  Forty-five (24.73%) EOC patients had preoperative thrombocytosis in this study. The mean platelet count in the EOC group was significantly higher than that of benign and healthy groups (P < 0.001). The MAR in the EOC group was significantly higher than that in the healthy group (71.96% vs 57.03%, P = 0.025). The platelet parameters (mean platelet volume, platelet distribution width, thrombocytocrit and large platelet ratio) were consistently higher in the EOC group than those in the benign and healthy groups, but the differences were insignificant. A significant correlation between thrombocytosis and MAR was observed in EOC patients (r = 0.694, P < 0.001). EOC patients with thrombocytosis were found to have significantly higher grade (P = 0.048), more advanced stage (P = 0.045), higher level carbohydrate antigen-125 (P = 0.007) and greater likelihood of suboptimal cytoreduction (P = 0.035). EOC patients with both thrombocytosis and high MAR were found to have shorter progression-free survival (P = 0.001)and overall survival (P = 0.004). The combination of thrombocytosis and MAR, as well as stage and optimal cytoreduction, retained significance as an independent prognostic factor for overall survival.
  
  
  CONCLUSIONS
  Thrombocytosis, accompanied by increasing of platelet aggregation rates, is associated with more aggressive tumor biology in EOC. The combination of thrombocytosis and MAR is an independent negative prognostic factor for overall survival in EOC patients.
authors.affiliation: Department of Gynecology and Obstetrics, Tianjin Medical University General Hospital, Tianjin, China.
authors.forename: Xuegong
authors.initials: X
authors.lastname: Ma
authors.forename: Yingmei
authors.initials: Y
authors.lastname: Wang
authors.forename: Hongna
authors.initials: H
authors.lastname: Sheng
authors.forename: Wenyan
authors.initials: W
authors.lastname: Tian
authors.forename: Zheng
authors.initials: Z
authors.lastname: Qi
authors.forename: Fei
authors.initials: F
authors.lastname: Teng
authors.forename: Fengxia
authors.initials: F
authors.lastname: Xue
mesh_terms: D001791:Blood Platelet Disorders / Q000209:etiology*; D000077216:Carcinoma, Ovarian Epithelial; D002681:China; D005260:Female; D006785:Hospitals, University; D006801:Humans; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D009375:Neoplasms, Glandular and Epithelial / Q000097:blood / Q000175:diagnosis / Q000503:physiopathology* / Q000601:surgery; D010051:Ovarian Neoplasms / Q000097:blood / Q000175:diagnosis / Q000503:physiopathology* / Q000601:surgery; D010053:Ovary / Q000473:pathology / Q000601:surgery; D010974:Platelet Aggregation; D010976:Platelet Count; D057234:Preoperative Period; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis; D013922:Thrombocytosis / Q000209:etiology*
keywords: epithelial ovarian cancer; platelet aggregation rate; prognosis; thrombocytosis